The Management and Follow-up of Orthodontic Forced Extrusion: A Case Report.
DOI:
https://doi.org/10.59334/ROV.v1i38.532Keywords:
Dental trauma, Dental fracture , Endodontics , Dental extrusion, dental restaurationAbstract
This clinical case focuses on the diagnosis and treatment of forced eruption in a patient with dental trauma.
Objective: To propose an alternative multidisciplinary treatment that allows increasing dental structure through forced extrusion and subsequently rehabilitating it in function and aesthetics.
Methods: We describe the case of a 78-year-old adult male patient, healthy and with no pathological history, who attended the Orthodontics and Dentomaxillofacial Orthopedics Specialty Clinic, referred by an Endodontics specialist, due to a crown-root fracture of the upper right canine, abutment of a three-unit fixed bridge. Intraoral examination revealed a cervical fracture of the crown of the upper right canine. As a first step, endodontic treatment was performed on the tooth and an intracanal support device was placed (cast endopost), in order to improve orthodontic traction. This device consisted of a cast post with perforations. Fixed appliances were placed in the upper arch using the MBT technique (slot 0.022), from the right molar to the left canine with indirect and passive cementation (with the bracket slots aligned). Immediately afterwards, a rectangular 0.019 x 0.025 stainless steel arch was placed with an extrusion bend at the level of the upper right canine. A helix-type loop was adapted to the same bend, which served as support for placing the passive ligature (lace back).
Results: The treatment carried out on this patient is satisfactory, contributing to his general health and improving his self-esteem.
Conclusion: Here, all the advantages offered by forced orthodontic extrusion were taken advantage of, even in an elderly patient, achieving a traction of four millimeters, which was achieved thanks to the use of light and controlled extrusive forces on the affected tooth. With the treatment modality described, crown lengthening can be achieved without the need for bone resection, which allows for proper prosthetic rehabilitation, restoring function and aesthetics to the injured tooth and providing a comprehensive benefit to the patient.
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References
Uribe et al., (2010). Ortodoncia Teoría y Clínica. Medellín, Colombia. Corporación para investigaciones biológicas.
Koyuturk & Malkoc, (2005). Orthodontic extrusion of subgingivally fractured incisor before restoration. A case report: 3‐years follow‐up. Dental traumatology, 21(3), 174-178. https://doi.org/10.1111/j.1600-9657.2005.00291.x
American Academy on Pediatric Dentistry Clinical Affairs Committee-Pulp Therapy subcommittee [AAPD], (2008). American Academy on Pediatric Dentistry Council on Clinical Affairs: Guideline on pulp therapy for primary and young permanent teeth. Pediatr Dent, 30, 175-183.
Forsberg & Tedestam, (1993). Etiological and predisposing factors related to traumatic injuries to permanent teeth. Swedish dental journal, 17(5), 183-190.
Andreasen & Ravn, (1972). Epidemiology of traumatic dental injuries to primary and permanent teeth in a Danish population sample. International journal of oral surgery, 1(5), 235-239. https://doi.org/10.1016/S0300-9785(72)80042-5
Andreasen, (1993).Textbook and color atlas of traumatic injuries to the teeth, 3rd ed. Copenhagen: Munksgaard; 216–256.
Arapostathis et al., (2006). A modified technique on the reattachment of permanent tooth fragments following dental trauma. Case report. Journal of Clinical Pediatric Dentistry, 30(1), 29-34. https://doi.org/10.17796/jcpd.30.1.p2611020q2762681
De Blanco, (1996). Treatment of crown fractures with pulp exposure. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 82(5), 564-568. https://doi.org/10.1016/S1079-2104(96)80204-6
Cavalleri & Zerman, (1995). Traumatic crown fractures in permanent incisors with immature roots: a follow‐up study. Dental Traumatology, 11(6), 294-296. https://doi.org/10.1111/j.1600-9657.1995.tb00507.x
Ojeda et al., (2011). Reattachment of anterior teeth fragments using a modified Simonsen’s technique after dental trauma: report of a case. Dental Traumatology, 27(1), 81-85. https://doi.org/10.1111/j.1600-9657.2010.00964.x
Keinan et al., (2013). Applying extrusive orthodontic force without compromising the obturated canal space. The Journal of the American Dental Association, 144(8), 910-913. https://doi.org/10.14219/jada.archive.2013.0208
Stockwell, (1988). Incidence of dental trauma in the Western Australian school dental service. Community dentistry and oral epidemiology, 16(5), 294-298. https://doi.org/10.1111/j.1600-0528.1988.tb01779.x
Andreasen, (1970). Etiology and pathogenesis of traumatic dental injuries A clinical study of 1,298 cases. European Journal of Oral Sciences, 78(1‐4), 329-342.
Spinas & Altana, (2002). A new classification for crown fractures of teeth. The Journal of Clinical Pediatric Dentistry, 26(3), 225-231.
Ellis & Davey, (1970). The classification and treatment of injuries to the teeth of children: a reference manual for the dental student and the general practitioner. Year Book Medical Publishers.
Ingber, (1989). Forced eruption: alteration of soft tissue cosmetic deformities. The International journal of periodontics & restorative dentistry, 9(6), 416-425.
Pontoriero et al., (1987). Rapid extrusion with fiber resection: a combined orthodontic-periodontic treatment modality. The International journal of periodontics & restorative dentistry, 7(5), 30-43.
May et al., (2013). Contemporary management of horizontal root fractures to the permanent dentition: diagnosis— radiologic assessment to include cone-beam computed tomography. Pediatric dentistry, 35(2), 120-124. https://doi.org/10.1016/j.joen.2012.10.022
Bondemark et al., (1997). Attractive magnets for orthodontic extrusion of crown-root fractured teeth. American journal of orthodontics and dentofacial orthopedics, 112(2), 187-193. https://doi.org/10.1016/S0889-5406(97)70245-2
Sönmez et al., (2008). Orthodontic extrusion of a traumatically intruded permanent incisor: a case report with a 5‐year follow up. Dental Traumatology, 24(6), 691-694. https://doi.org/10.1111/j.1600-9657.2008.00676.x
Saito et al., (2009). Management of a complicated crown‐root fracture using adhesive fragment reattachment and orthodontic extrusion. Dental Traumatology, 25(5), 541-544. https://doi.org/10.1111/j.1600-9657.2009.00811.x
Grossman, (1966). Intentional replantation of teeth reimplantation. Asociación J Am Dent, 72 (5): 1111-8. https://doi.org/10.14219/jada.archive.1966.0125
Kumar et al., (2019). Management of subgingival root fracture with decoronation and orthodontic extrusion in mandibular dentition: A report of two cases. Contemporary Clinical Dentistry, 10(3), 554. https://doi.org/10.4103/ccd.ccd_736_18
Campbell et al., (1975). Orthodontically corrected midline diastemas: A histologic study and surgical procedure. American journal of orthodontics, 67(2), 139-158. https://doi.org/10.1016/0002-9416(75)90066-4
Carvalho et al., (2006). Orthodontic extrusion with or without circumferential supracrestal fiberotomy and root planing. International Journal of Periodontics & Restorative Dentistry, 26(1), 87-93.
Bach et al., (2004). Orthodontic extrusion: periodontal considerations and applications. Journal (Canadian Dental Association), 70(11), 775-780.
Edwards, (1988). A long-term prospective evaluation of the circumferential supracrestal fiberotomy in alleviating orthodontic relapse. American Journal of Orthodontics and Dentofacial Orthopedics, 93(5), 380-387. https://doi.org/10.1016/0889-5406(88)90096-0
Brain, (1969). The effect of surgical transsection of free gingival fibers on the regression of orthodontically rotated teeth in the dog. American journal of orthodontics, 55(1), 50-70. https://doi.org/10.1016/S0002-9416(69)90173-0
Durham et al., (2004). Rapid forced eruption: a case report and review of forced eruption techniques. General dentistry, 52(2), 167-75.
Suprabha et al., (2006). Reattachment and Orthodontic Extrusion in the management 9f an incisor crown-root fracture: A case report. Journal of Clinical Pediatric Dentistry, 30(3), 211-214. https://doi.org/10.17796/jcpd.30.3.1w6563784l101nx9
Jorgensen & Nowzari, (2001). Aesthetic crown lengthening. Periodontology 2000, 27(1), 45-58. https://doi.org/10.1034/j.1600-0757.2001.027001045.x
Yoshinuma et al., (2009). Orthodontic extrusion with palatal circumferential supracrestal fiberotomy improves facial gingival symmetry: a report of two cases. Journal of Oral Science, 51(4), 651-654. https://doi.org/10.2334/josnusd.51.651
Gonçalves et al., (2015). A mixed-model study assessing orthodontic tooth extrusion for the reestablishment of biologic width. A systematic review and exploratory randomized trial. International Journal of Periodontics & Restorative Dentistry, 35. https://doi.org/10.11607/prd.2164
Simon et al., (1978). Extrusion of endodontically treated teeth. The Journal of the American Dental Association, 97(1), 17-23. 35. https://doi.org/10.14219/jada.archive.1978.0454
Farmakis, (2018). Orthodontic extrusion of an incisor with a complicated crown root fracture, utilising a custom-made intra-canal wire loop and endodontic treatment: a case report with 7-years follow-up. European Archives of Paediatric Dentistry, 19(5), 379-385. https://doi.org/10.1007/s40368-018-0373-5
Newman (1992). Ortodoncias limitada para la población mayor: modalidades multidisciplinarias. Revista estadounidense de ortodoncia y ortopedia dentofacial , 101 (3), 281-285. https://doi.org/10.1016/0889-5406(92)70098-U
Marianne et al., (2002) Tratamiento de periodoncia y ortodoncia en adultos. Am J Orthod Dentofacial Orthop, 122:420-428.
Heithersay (1973). Tratamiento combinado endodóntico-ortodóncico de las fracturas radiculares transversales en la región de la cresta alveolar. Cirugía Oral, Medicina Oral, Patología Oral , 36 (3), 404-415.
Girón, F. H., & Fernández, S. T. (2014). Ortodoncia en un paciente adulto mayor. Revista Mexicana de Ortodoncia, 2(3), 196-203. https://doi.org/10.1016/S2395-9215(16)30035-6
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